When do the 2 peaks during the gait cycle occur?

Women, because their legs account for a smaller percentage of total body height which means they must strike the ground more often to cover the same distance

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What does gait involve?

The displacement of body weight in a desired direction

29

What are the 5 priorities of normal gait?

- Stability of the weight bearing foot throughout the stance phase- Clearance of the NWB foot during the swing phase- Appropriate prepositioning of the foot during terminal swing for the next gait cycle - Adequate step length- Energy conservation

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In order for gait to be efficient and to conserve energy what must/must not occur?

the COG must undergo minimal displacement

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What are the 6 determinants have the potential to reduce the energetic cost of human gait?

Describe Equinus Gait

The forefoot strikes first to initiate the gait cycle.There is premature plantarflexion in early midstance. Increased flexion at the knees in stance phase.Delayed or diminished knee flexion in swing phase.Diminished hip extension.Increased anterior pelvic tilt.

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Describe Gluteus Maximus Gait

Posterior thrusting of the trunk at initial contact in an attempt to maintain hip extension of the stance leg Anterior tilt of the pelvis causes hyperlordosis

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What is gluteus maximus gait due to?

weak hip extensors

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How do people with weak quadriceps tend to compensate?

The affected LE is circumducted and the patient leans toward the uninvolved side to balance the COG

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People with weak quadriceps tend have difficulty walking on what types of surfaces?

rough or uneven surfaces

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What is steppage gait due to?

foot drop

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Describe steppage gait

There is increased hip and knee flexion to compensate for decreased dorsiflexion and the foot tends to make an audible slap on the floor

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What is Trendelenburg Gaitdue to?

weakness of the hip abductors

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What is plantar flexor gait due to?

Premature firing of the gastroc during the swing phase

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What is plantar flexor gait characterized by?

toe walking

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plantar flexor gait is a common deviation in what type of patient?

children with CP

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What causes spastic hemiplegic gait?

Unilateral UMN lesion

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Describe spastic hemiplegic gait

The LE circumducts and the UE is carried across the trunk for balance

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What causes spastic paraparetic gait?

Bilateral UMN lesions

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Describe spastic paraparetic gait

Slow, stiff and jerky movementsSpastic extension occurs at the kneesAdduction at the hips causing "scissors gait"

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Describe ataxic gait

Walking is characterized by a widened base, high stepping, staggering or lurching from side to side

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What is the difference bewteen cerebellar and sensory gait?

Cerebellar: broad based, unsteady and staggering with an irregular swaySensory: patient tends to lift the feet too high and slap on the floor in an uncoordinated manner

What are 3 gait chances that occur with age?

- A transition from ankle strategy back to hip strategy during gait- A broadened stance to combat increased med-lat instability- A shortened stride length to better maintain COG

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Describe ideal postural alignment

A straight line that passes through: - The ear lobe - The bodies of the cervical vertebrae - The tip of the shoulder - Midway through the thorax - Through the bodies of the lumbar vertebrae - Slightly posterior to the hip joint - Slightly anterior to the axis of the knee joint - Slightly anterior to the lateral malleolus

Slouched posture causes decreased mobility in what muscles?

Slouched posture causes which muscles to become stretched and weakened?

- lower abdominals- distal thoracic extensors- hip flexors

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Flat back posture causes decreased mobility in what muscles?

trunk flexors and hip extensors

100

Flat back posture causes which muscles to become stretched and weakened?

lumbar extensors and hip flexors

101

Round back posture with forward head causes decreased mobility in what muscles?

- anterior thorax muscles (intercostals)- muscles of the UE originating on the thorax (pecs, lats and serratus)- muscles of the cervical spine and head that attach to the scapulae and upper thorax (levator, SCM, scalenes, upper traps)- suboccipital muscles (rectus capitis post major and minor, Obliquus capitis inf and sup)

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Round back posture with forward head causes which muscles to become stretched and weakened?

What is the purpose of gait interventions?

to alleviate symptoms and educate the patient in correct posture

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What are the 3 things gait interventions focus on?

Restoration of normal length of the muscles- Strengthening of the muscles that have become inhibited and weak- Establishment of optimal motor patterns to secure the best possible protection of the joints and the surrounding soft tissues